Pain Connection Blog

with Dr. Mehta

Medical research into pain management has come a long way since it began in earnest in the 1960s. Early reliance on surgical procedures and potentially addictive medication gradually gave way to noninvasive techniques such as physical therapy, biofeedback, therapeutic massage, and yoga, to name just a few.

But if you assume that there are just so many ways for a physician to deal with a patient’s pain, it may surprise you to learn that research into the field of pain management is continuous and constantly finding new ways to bring relief.

As one might expect, the latest developments have focused on new technologies.

Spinal Cord Stimulation

In fact, a recent clinical trial examined a new form of spinal cord stimulation (SCS) and found that it reduced chronic pain for patients with back and leg pain caused by common spine pain diagnoses – including failed back syndrome, radiculopathy (nerve root pain), and degenerative disc disease – compared to conventional SCS.

Two-thirds of patients with chronic spine pain who participated in the clinical trial achieved a major reduction in their pain with the new SCS compared to only one-third who had less pain with a conventional SCS device. Researchers followed up two years later and found the same results. The likely reason for this result is a change in the way the new device was programmed, enabling patients to better enjoy their work and other activities.

Another trial involved a new type of neuromodulation device used to treat complex regional pain syndrome (CRPS). Ordinarily, it is the dorsal column that is stimulated. However, the new device was applied to the dorsal root ganglion near the spinal nerve. This resulted in 70 percent of patients who participated in the study achieving an 80 percent decrease in pain compared to 52 percent with conventional treatment.

Until recently, battery life for SCS devices was a major concern for pain management specialists. This has long been a concern of pain management specialists. However, with the advent of wireless technology, pain doctors are increasingly optimistic about the future of implanted SCS and other devices as a means of treating a wide range of nerve pain disorders, including diabetic neuropathy, postherpetic neuropathy (a complication of shingles), phantom limb/stump pain following amputation, and central neuropathic pain disorders.

Other Research Affecting Pain Management

In addition, researchers have been studying and developing:

New radiofrequency ablation devices to deal with chronic and geriatric pain conditions.

Noninvasive, electroceutical devices like the ActiPatch® that use electromagnetic fields to modulate nerve activity and dampen the brain's perception of pain. These are used as a treatment for chronic pain from osteoarthritis, rheumatoid arthritis, neuropathy, sports injuries, fibromyalgia, and post-surgical pain.

At Pain Specialists of Austin, our highly qualified doctors use the latest, state-of-the-art technology, along with tried and true conventional methods to ease and manage your pain. Our goal is to provide you with the exceptional care you need to start feeling better again.

So, if you are suffering from any form of pain that is negatively impacting the quality of your life, call us at (855) 876-7246 (PAIN) to make an appointment to discuss your treatment options. You can also use our convenient appointment request form. We look forward to helping you get back to enjoying a pain-free life.

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Different Types of Pain Management Injections and How they Can Help You

This is an open letter to those suffering from pain.

Long-term, persistent pain is nothing like the pain of an acute injury or even a really bad case of the flu. In those cases, you may feel bad – really bad – for days or weeks, but the pain gradually lessens, letting you know that you’re on the mend. Chronic pain, on the other hand, is unpredictable and unrelenting. It can occur every day, or it may appear on random days. But there is never any indication you are getting better. With pain like this, you may feel fine one day, then can barely move the next. You will find your life – and plans – in constant flux, never being able to predict when or how the pain will strike.

Living with chronic pain is tough but finding relief for it is even more so. Getting an accurate diagnosis for what ails you and finding a treatment that works typically involves a lot of trial and error. That’s where interventional pain management comes in, utilizing mostly minimally invasive techniques to lessen a patient’s pain.

Pain Management Injections

Pain management injections are safe, effective, and can provide longer-term solutions than, say, oral medications – and are a less invasive option than surgery, to boot. They are used to treat a wide variety of orthopedic or neurological conditions and injuries.

One of the most common pain management injections is called an epidural steroid injection. This injection is common for lower back pain but may also help with upper back and neck pain. When injected, steroidal medication is injected into the epidural space around the spinal cord. The medication reduces inflammation and pain.

Nerve blocks are another common pain management injection. These injections deliver an anesthetic close to particular nerves, in an effort to interrupt nerve signals before they can get to the brain, where they would register as pain. These injections are used to treat pain caused by inflamed nerves and can be used to help identify the source of your pain.

Joint injections deliver medication into the joints for quick relief of pain and inflammation. Trigger point injections can help relax knots of muscles that may be causing pain in other parts of the body (for example, a trigger point in the neck is a common cause of tension headaches).

At Pain Specialists of Austin our interventional pain management doctors are here with one goal: to relieve chronic pain and help our patients return to being their former active selves. Instead of relying on medication, we intervene in a much more effective manner using a vast array of therapies such as pain management injections, to help relieve pain. We aim to improve one’s quality of life and help to regain function and mobility.

To learn more about interventional pain management, and how pain management injections may help you, call the Pain Specialists of Austin at (512) 485-7200 to request an appointment, or request an appointment online.

What Does A Pain Management Doctor Do?

Pain management doctors – physicians who specialize in the evaluation, diagnosis, and treatment of pain – have advanced training that qualifies them as your best source of treatment if you are experiencing any type of pain due to illness or injury.

After a general residency, these physicians undergo an additional one-year fellowship in pain management, and they are board-certified in a specialty, such as sport injuries or cancer pain.

However, most pain management doctors devote their time and expertise to helping chronic pain patients whose needs can sometimes be hard to diagnose and take months or years to treat using multiple therapies.

Pain management doctors most often see patients with pain in the low back, knee, head, hip, and neck. Common conditions treated is these physicians include: arthritis, fibromyalgia, migraines, sciatica, and more.

But what do pain management doctors actually do?

For one thing, they diagnose the specific cause of your pain and the underlying conditions that lead to it. Take back pain, for example. It could be caused by many conditions ranging from poor posture at your work desk to a herniated disc to a degenerative condition like arthritis.

Once a pain management doctor diagnoses your pain, he or she can find the therapy that works best for you based on their specialized training and the latest research. In fact, pain management doctors often conduct their own trials and studies on patients who haven’t responded to conventional treatments.

Pain doctors often use a wide range of nonsurgical, interventional treatments – along with complementary therapies – as a way of reducing the amount of medication you need to take or to avoid the need for surgery. These may include massage, a weight loss regimen, acupuncture, exercise, yoga, meditation, physical therapy, dietary changes, or chiropractic care.

They may also prescribe pain-killing medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or antidepressants. Depending on the severity of your specific condition, they may also recommend epidural steroid injections, nerve blocks, joint injections, radiofrequency ablation, spinal cord stimulation, or neuromodulation. If none of these methods are effective in alleviating your pain, surgery may be an option of last resort.

In any case, your pain management doctor will coordinate treatment between multiple doctors and healthcare professionals. In addition, he or she will continue ongoing care for any physical or mental concerns you may have. In that role, your pain management doctor acts as an advocate dedicated to relieving your symptoms.

To learn more about how a board-certified pain management doctor can help you overcome your pain issues, talk to the experts at Pain Specialists of Austin. We help patients like you every day. Get the discussion started by calling (512) 485-7200 for an appointment today. We have 10 convenient locations in and around the Austin, Texas, area. You can also request an appointment online.

Cancer Pain Management

Getting a cancer diagnosis is a shock, to say the least. The C-word is a word no one wants or expects to hear, but it is an unfortunate reality to far too many people. Cancer can also be a genetic disease, meaning some are born genetically predisposed to developing certain types of cancer. People with hereditary mutations have a higher risk of developing the disease more than the average person. Early diagnosis and an increasing amount of treatment options give people more hope for battling cancer, but there can still be a great deal of pain that needs to be managed along the way.

Dealing with a cancer diagnosis, whether metastatic or curable, is devastating and can be hard to cope with no matter what the stage is. One often feels anxious about how to proceed, but there is a light at the end of the tunnel, and your healthcare team is there to help see you through the tough times.

There is more to cancer care and treatment than simply helping patients survive. Cancer, like any other chronic disease, can cause serious pain that affects one’s quality of life in conjunctions with the disease itself. Pain is an important indicator that something is wrong, and therefore, ignoring it is a bad decision. Early detection of any disease, but especially cancer, is imperative and can save your life or the life of a loved one.

People with cancer often think there is no hope, and that their pain cannot be managed the way other conditions might. In fact, there are pain management techniques specifically catered to those suffering from cancer pain, or the pain associated with certain cancer treatments. If a proper care plan is put into place, it can improve one’s quality of life significantly, and may ultimately save lives. Cancer patients should not hesitate to get the treatment that they need.

At Pain Specialists of Austin, when other methods of treatment fail to provide sufficient, long-lasting relief from cancer pain, it’s time to consult a doctor who specializes in pain management. Our interventional pain management specialists can perform a variety of interventional and minimally invasive procedures, such as injections to help with cancer pain.

We believe the best way to manage your cancer pain will depend on the type of pain you are experiencing, and to what degree. At Pain Specialists of Austin, we mainly use special nerve blocks to keep the pain signal from reaching your brain and inject the area in need of pain relief. Our methods of pain relief are unlike regular methods such as over-the-counter anti-inflammatories because the interventional methods that we utilize. Pain medication injections directly target the source of your pain, resulting in more long-term pain relief.

You might feel that because you have cancer, pain should be an expected side effect that you just need to suffer through. No one should have to live with pain that interrupts their life, especially so when faced with the uncertain and often frightening possibilities that come with cancer treatment. We can help. Call (512) 485-7200 to request an appointment with one of our pain specialists, or request an appointment online.

Managing Cancer Pain

Millions of Americans are diagnosed each year with cancer. While not all cancers cause pain, cancer pain can be a significant part of the cancer symptoms for many patients. Research shows that as many as one out of every three cancer patients struggle with some degree of significant cancer pain. At one time, there were few options for dealing with pain caused by cancer, but new developments in medical care are helping patients fight their battle with less discomfort and greater hope.

Managing Cancer Pain

Cancer is a complex disease. Which is why cancer pain can be caused by one of several factors, including pain caused by the cancer itself, or from the form of treatment required (such as radiation or surgery). Therefore, cancer pain treatment must be addressed based on your specific needs and the underlying causes of your pain. Not only does reducing or eliminating cancer pain improve your quality of life, it is an important part of your overall treatment.

Simply put, cancer pain can sap your mental and physical resources, making it harder to fight the disease. Cancer pain can interfere with your ability to sleep, affect personal relationships, and even change your overall outlook on life. At the Pain Specialists of Austin, we understand all forms of pain and pain management. We know that appropriate interventional pain management may help you reduce the need for medications, and enable you to live and function more normally.

Depending on the nature of your cancer pain, a multipronged or stepped approach may be required. That is why we offer advanced spine diagnostics coupled with leading edge treatments such as minimally invasive spine procedures, steroid injections, nerve blocks, neurostimulation, intrathecal spinal pumps, medications, physical therapy, and more to help reduce the impact of pain, so that you can focus on fighting the cancer.

Our sophisticated interventional pain procedures can often block pain for months at a time. Spinal cord stimulation (Neurostimulation) for example, is a minimally invasive procedure that can treat chronic pain in the trunk or limbs. After a successful 7-day trial with a spinal stimulator, electrodes are surgically attached to the nerves in your spinal cord.

Other options include treatments such as an intrathecal spinal pump (This is an implanted electronic device that delivers pain medication to the spinal cord through a small catheter). This can help to decrease or even eliminate the need to take medication orally. An experienced medical psychologist must evaluate the patient and have them undergo an intra-spinal medication trial. If successful, the patient will then receive a referral for surgery to receive the permanent implant.

Only a qualified physician can advise you about which cancer pain management treatments are right for you. If cancer pain is interfering with your recovery, or lowering the quality of your life, we can help. Please call 512-485-7200 today, or request an appointment online. Our caring staff will be there every step of the way. Call now.

Orthopedic Doctor Vs. Pain Doctor

Your physical condition and wellness priorities determine whether you should schedule an appointment with an orthopedist or a pain doctor. The decision is dependent upon your ultimate goal.

If you want to find out the source of pain you're experiencing and how the pain should be addressed, then making an appointment with a pain doctor is appropriate.

If it's more important for you to resolve musculoskeletal concerns outside of pain, then seeing an orthopedist is preferable.

An orthopedist's goal is to restore your musculoskeletal system's function, strength, and mobility, and then put you on a maintenance plan. Orthopedists have a crucial role working with other physicians and health care workers to optimize your well-being.

What Does a Pain Doctor Do?

Pain management doctors are certified, degreed physicians who are able to treat both chronic and acute pain. A pain specialist usually treats pain as a symptom of an underlying disease, including arthritis, cancer, migraine headache, fibromyalgia, and more. But pain doctors also treat primary pain disorders and acute pain from illness or injury, as well as offer palliative care.

If suffering from pain due to disease, an injury, or post-surgery, you can expect your pain doctor to address it and consult with other specialists to coordinate your care.

Your pain doctor devises an individual treatment plan that utilizes non-invasive treatments as much as possible.

What To Expect At Your First Pain Management Visit

Your pain doctor uses a variety of techniques to diagnose and then treat your pain based on its root cause. The doctor evaluates your condition by taking a family medical history, as well as a personal history.

Following the initial assessment, your doctor might order diagnostic testing. Those tests could include imaging, blood work, stress tests, and more. A physical examination is also conducted.

Once the pain source is identified, the doctor creates a plan to manage or reduce the pain.

Pain Treatment Options

In most cases, pain treatment is non-invasive. However, there are situations where minimally invasive treatments like the following are warranted and necessary:

Pain Relief in Austin

At Pain Specialists of Austin, we provide a multidisciplinary approach to managing your pain. We are sensitive to the needs of anyone suffering from chronic pain – whether it's caused by illness, disease, or injury – and we understand how to treat it.

Whoever coined the saying “Pain of mind is worse than pain of body” probably never experienced chronic pain. Chronic pain can be caused by a number of factors – genetics, anxiety, injury, or disease; and in some cases, doctors might have difficulty discovering just what it is that is leaving their patients in peril. According to a National Health Institute study, 11.2% of all Americans suffer from chronic pain.

It’s important to understand the difference between acute and chronic pain. Acute pain is severe or sudden and can be attributed to something that you can pinpoint, for example, a surgery, illness, or accident. Chronic pain, on the other hand, is persistent – lasting for months and possibly longer. In many cases, physicians can go to great lengths to detect the root of this mysterious malady. It often takes patience and multiple visits to medical specialists before a diagnosis can be made.

One of the first steps to diagnosis is rating your pain. How we describe our pain can reveal a lot of valuable information to our physicians. Numerical ratings are sometimes used as a scale; in other cases, doctors may ask you to keep a journal or log of your pain, or to describe your pain in words. One famous verbal rating scale is known as the McGill Pain Questionnaire. All of these assessments are key factors in determining whether the cause of our discomfort is muscular or neurological in nature. There are many tip-offs, but pain that is described as having a burning, tingling, or “pins and needles” feeling leans toward nerve pain, whereas a tender, throbbing, or stiffness is indicative of muscle pain. For those who have trouble communicating, or exhibit mild cognitive impairments, tests such as Wong-Baker and Observer scales make assessments based on facial expression and heart rate.

According to a study published by the National Institutes of Health, there are over 30 years of research and evidence that verify the importance and validity of psychological assessment in chronic pain evaluation. Anxiety and depression often coincide with the incidence of chronic pain; in fact, in those experiencing chronic pain, concurrent depression occurs in up to 52% of those in pain clinics. It’s a vicious cycle, as depression can cause chronic pain, but chronic pain can also lead to depression.

Physical and neurological exams will delve deeper into the ratings test information collected previously. A comprehensive physical exam will allow your doctor to examine your strength and posture, as well as denote any abnormalities that could be the culprit of your chronic pain. Your physician will most likely check your balance, reflexes, and coordination, as well.

Bloodtests are never a bad idea. Most people know the value of having their blood tested yearly for lipids, cholesterol, and so on. However, did you consider the role these factors are playing in your pain? Blood tests are highly valuable for ruling out causes of your pain that may have gone under the radar. Everything from vitamin deficiencies to autoimmune disorders can be validated with a simple vile of blood. Persistent pain in muscles and joints has been linked to a sluggish thyroid, while achiness coincides with a lack of Vitamin D.

If the abovementioned diagnostics point to nerve damage, there are a number of supplemental tests that can be administered. Measuring the speed at which an electrical impulse travels through your nerve, Nerve Conduction Velocity (NCV) tests are advantageous for diagnosing pain disorders such as Guillain-Barré syndrome, Carpal Tunnel Syndrome, and Sciatic nerve problems. Often usedin tandem with NCV tests, Electromyography (EMG) involves the insertion of a needle into the muscle to record electrical activity. Electrical activity in a “resting” muscle is a sure-fire sign of a muscle or nerve disorder, or inflammation.

One thing is clear: there’s no one-size-fits-all approach to diagnosing chronic pain. Pain Specialists of Austin offers a comprehensive approach to diagnosis and treatment, and has the tools needed to tackle everything from spine disorders, to cancer pain management. For more information, call 512-485-7200.